Healthcare Provider Details

I. General information

NPI: 1417909888
Provider Name (Legal Business Name): TARUN K OHRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 BROOKLYN ST
WARSAW NY
14569-1413
US

IV. Provider business mailing address

161 BROOKLYN ST
WARSAW NY
14569-1413
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-3106
  • Fax:
Mailing address:
  • Phone: 585-786-2005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number138960
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: